Mental Health Clients Research Articles

Inspiring Careers in Mental Health: Piloting a Pipeline Program for Underserved High School Students.

Given mental health workforce shortages, academic psychiatry departments have a compelling interest in developing pipeline programs. This article examines a pilot program for high school students within an academic psychiatry department, assessing whether it successfully informs students about mental health career options and increases their interest in them. The authors recruited all program participants in 2022 and 2023 during data collection. The program served as an intervention, teaching participants about mental health career options, clinical practice, and client experiences via presentations from psychiatrists and other mental health professionals. Participants completed a pretest at the start of the two-week program and a posttest at the end. On both the pretest and posttest, participants rated their agreement with 22 statements relating to mental health career knowledge, attitudes, and interest. The authors analyzed the data using dependent means t tests. The program increased participants' knowledge of the roles and paths to pursuing different mental health careers. It also increased participants' belief that they could pursue a mental health career. The program improved some but not all measured attitudes toward mental health and mental health careers. In 2023, the program increased participants' likelihood of pursuing a mental health career. A pipeline program for underserved high school students delivered by an academic psychiatry department is feasible, and it was effective in changing attitudes and increasing the likelihood of pursuing a mental health career.

Domestic and Family Violence Screening and Response: A Prospective, Cross-Sectional, Mixed Methods Survey in Private Mental Health Clients.

Most domestic and family violence (DFV) research has focused on establishing prevalence and screening rates in public health and community samples. This study sought to address a gap in the literature by evaluating DFV screening and response practices in a private mental healthcare inpatient service and determining if clients of the service had unmet DFV needs. A prospective, convenience sample, mixed methods, cross-sectional survey of adult inpatient mental health consumers was employed. Sixty-two participants completed the Royal Melbourne Hospital Patient Family Violence Survey. Quantitative Likert-type and categorical responses were collated and analysed descriptively (count and percentage). Free-text responses were analysed using qualitative description within a content analysis framework. Sixty-five percent of participants had been screened for at least one DFV issue, on at least one occasion, with 35% not being screened, to their recall. Twenty-three percent reported disclosing DFV concerns, 82% felt very supported by the clinician's response to their disclosure, and 86% were provided with information they found helpful. Unmet needs were identified in 13% of participants, who had wanted to disclose DFV concerns but not feel comfortable to do so. No unscreened respondents disclosed DFV concerns, highlighting the need to uphold best practice guidelines for direct enquiry. Most disclosing clients were positive about the support they received. Indicated areas for improvement were screening rates, active follow-up, increasing psychology support levels and safety planning.

Current Mental Health Clients’ Religious/Spiritual Beliefs and Practices: A National Survey

Abstract This article describes the results of a cross-sectional survey of current mental health clients’ religious/spiritual beliefs and practices, as well as how clients perceive such practices as influencing their mental health. A total of 989 self-identified mental health clients across the United States completed an anonymous online survey in 2018. This survey included several items and instruments to measure clients’ religious affiliation, religious/spiritual beliefs and practices, and a new set of items to assess the degree to which clients perceive their religious/spiritual practices impacting their mental health. The results of descriptive, correlation, and chi-square analyses indicate religion/spirituality (RS) play a nuanced and complex role in most clients’ lives, with a majority reporting positive views related to their RS and indicating they consider their religious/spiritual practices to be helpful when it comes to their mental health. Further, there are several noteworthy similarities and differences between mental health clients’ religious/spiritual beliefs and practices as compared with those of the general U.S. population during 2018 as well as a national sample of licensed clinical social workers in 2013. Based on these findings, implications and considerations are discussed for social work practitioners serving mental health clients, and for educators training the next generation of social workers.

Things to consider affecting secure, avoidant-fearful, and preoccupied attachment among mental health clients

Working alliance (WA) has been demonstrated to be a critical factor affecting treatment effectiveness. The relationship between patients' fundamental perceptions of attachment of WA and the efficacy of treatment as a result is becoming more widely acknowledged. To discover and examine the variables that affects the growth of solid attachment, avoidant-fearful attachment, and preoccupied attachment in psychologically ill patients. The research particularly seeks to investigate the many variables that influence these diverse kinds of attachments in people needing psychological treatment. The main healthcare psychologists enrolled 303 individuals who were scheduled for counseling. Self-report surveys on mental disorders, WA, and attachments were filled out by respondents. Participants who felt safer in their relationship with the psychotherapist displayed considerably higher WA. Increase in result was also connected with initial attachments to the psychotherapist in a subset of patients who finished treatment. According to the research, therapeutic connection is a significant WA prediction. According to the findings, connection to a psychotherapist might be more significant in regards to WA that previous attachments patterns.

Trends in Mental Disorders in Children and Adolescents Receiving Treatment in the State Mental Health System

To examine recent trends in clinical diagnoses of children and adolescents receiving treatment in publicly funded mental health treatment services in the United States. Data on children and adolescents (≤17 years) receiving treatment from publicly funded mental health treatment services recorded in Mental Health Client-Level Data 2013-2021 (total number of records= 13,684,154) were used to examine temporal trends in the proportion of different child and adolescent psychiatric disorders. Trends were examined overall and in age, sex, racial/ethnic, and service strata focusing on community-based programs. The analyses revealed increases in the proportion of anxiety disorders from 9.6% in 2013 to 19.2% in 2021 (adjusted odds ratio [AOR] 2.17, 95% CI 1.85-2.55, p< .001), trauma- and stressor-related disorders from 22.7% to 27.4% (AOR 1.31, 95% CI 1.09-1.57, p= .004), and depressive disorders from 13.4% to 17.0% (AOR 1.20, 95% CI 1.03-1.41, p= .04). During this same period, the proportion of bipolar disorders declined almost 8-fold from 10.0% to 1.3% (AOR 0.07, 95% CI 0.06-0.09, p< .001). The proportion of conduct disorder and oppositional defiant disorder also declined from 9.7% to 4.4% (AOR 0.42, 95% CI 0.32-0.55, p< .001) and from 11.1% to 7.8% (AOR 0.79, 95% CI 0.65-0.98, p= .03), respectively. Trends varied across sex, age, and racial/ethnic strata. The composition of childhood psychiatric diagnoses in patients within publicly funded mental health treatment settings changed over the past decade. While some of the trends may reflect changes in diagnostic practices of clinicians, increases in anxiety and depressive disorders parallel trends in the prevalence of these conditions in the general population and highlight a growing need for identifying and treating these conditions in this age group.

Art on the skin, lifesaving within: Exploring the role of tattoo artists in suicide prevention.

Different populations experience suicide at different rates. Some studies have found an increased risk of suicide among individuals with tattoos. Studies indicate a higher prevalence of mental health disorders among individuals with one or more tattoos. These findings signal a need to explore suicide prevention in tattoo shops. The aim of this project is to determine the feasibility, acceptability, and interest of providing education on suicide prevention among tattoo artists. We conducted a cross-sectional survey with tattoo artists. Survey items assessed artists' experiences with clients expressing mental health issues or suicidal thoughts, their comfort level assisting clients, and general perceptions around suicide and stigma. Seventy-nine surveys were collected. Most artists reported that they have had at least one situation in which a client mentioned something that made them concerned about that client's mental health. Most respondents reported that a client has expressed suicidal thoughts to them at least once. Our study demonstrated that tattoo artists encounter clients who express mental health challenges as well as suicidal ideation, underscoring the potential role for tattoo artists in supporting individuals at risk for suicidal thoughts and behaviors.

Helpful and Harmful Approaches to Integrating Religion and Spirituality into Mental Health Care: A National Survey of Current Clients' Experiences in the United States.

This article describes a national sample of 989 current mental health clients' views regarding whether and how their mental health care providers integrated the client's religion/spirituality (RS) into treatment. Within the online Qualtrics survey, two open-ended items asked respondents what (if anything) the client perceived their therapist having done regarding the client's RS that was (1) helpful/supportive or (2) hurtful/harmful. Participants also reported various ways therapists included the topic of RS in practice, if any. Nearly half freely described helpful ways their providers integrated the client's RS, and half indicated it was not discussed or applicable. Although 9.6% described hurtful experiences, most indicated their provider had not done anything harmful related to integrating RS. Implications for practice and training across mental health disciplines are discussed.

Occupational therapists views on GAS-light as an outcome measure in community adult mental health

PurposeThe paper aims to gain understanding of perceived benefits and barriers to GAS-light as an occupational therapy outcome measure in community adult mental health. The study explored occupational therapists’ views on the client-centred nature of GAS-light and whether it is an applicable outcome measure for group intervention. It also aimed to understand how occupational therapists use of GAS-light informed their practice and the wider multidisciplinary team perspective.Design/methodology/approachThe study used a phenomenological design. This comprising of a focus group of occupational therapists experienced in using the tool, followed by framework analysis. Focus group questions were derived from literature.FindingsThree main themes were identified to reflect experiences relating to the GAS-light tool as an outcome measure; value in process, occupational narrative and language and expertise.Practical implicationsThe paper is indicative of practical implications regarding the use of the GAS-light tool with community mental health clients and therapists, including the perceived value in the process, the language used by the therapist and level of expertise.Originality/valueThis paper fulfils an identified need to contribute towards an evidence base for occupational therapy and mental health.

Almost one in five emergency department presentations are by mental health clients: a secondary data analysis.

Mental health-related emergency department (ED) presentations are steadily increasing, including presentations for both mental health and non-mental health concerns by existing clients of mental health services. The study aim was to examine and compare mental health clients and non-clients' ED presentations, identify data and clinical gaps and make recommendations for improvement. De-identified 2017/2018 ED data were used to describe presentations for current and recent (within last 5 years) clients of specialist public mental health and addiction services, compared to presentations of non-mental health clients. Of 49,170 presentations, 18% were by clients of mental health services. Compared to other ED presenters, mental health clients were often younger, female and Māori, required more urgent care and waited longer. Mental health-related International Classification of Diseases (ICD) codes/referrals were most common for presentations by current mental health clients, whereas pain and trauma were often the reason for prior mental health clients' presentations. Discharge diagnoses rarely included self-harm behaviour, and admissions for these clients were more commonly by ED rather than mental health services. Mental health clients are common in ED. Enhanced mental health data capture and improved systems and processes are needed to ensure that ED staff can better meet their often-complex needs.

Predictors of family-focused practices among mental health workers in Quebec.

Engaging family members in the ongoing care of individuals with mental illness is a practice known to bolster the client's recovery journey and enhance the overall wellbeing of both children and families involved. Despite its potential benefits, there remains a dearth of understanding surrounding the implementation of family-focused practices (FFP) by mental health professionals serving adults, as well as the factors that could either promote or hinder such practices. This knowledge gap is particularly pronounced within North American settings. The goal of this study was to identify potential hindering and enabling factors of FFP used in adult mental health services. A sample of 512 professionals working with adult mental health clients, from all regions of Quebec, Canada, with a variety of disciplinary backgrounds and working in different work settings, completed the Family Focused Mental Health Practice Questionnaire (FFMHPQ). Multinominal logistic regression analysis was performed to assess the impact of several factors - organizational, professional, and personal - on the degree of family-based practices of mental health workers. Findings of this study show that the strongest predictors for the adoption of higher FFP levels among adult mental health professionals in Quebec, are being employed on a full-time basis, perceiving a higher level of skills, knowledge, and confidence toward FFP, and having a supportive workplace environment. Results underscore the need to address both organizational and worker-related aspects to effectively promote better FFP in mental health services.

Mental health clients’ receptiveness to and recommendations for integrating physical activity discussions into therapy: a mixed methods study

Objective The mental health benefits of physical activity are well-established. Integrating physical activity counseling into therapy would expand the reach of this evidence-based treatment for mental illness. This mixed methods study examined mental health clients’ receptiveness and recommendations for effectively discussing physical activity in therapy. Methods A diverse sample of U.S. adults in therapy (N = 478) completed a survey that included the open-ended question: What specific recommendations would you have for your therapist to effectively discuss physical activity with you? We conducted a qualitative content analysis to identify their most common recommendations. Results Most participants indicated they would be comfortable discussing physical activity with their therapist. The content analysis resulted in 26 unique categories; most common recommendations included: provide information about what to do (n = 81), discuss physical activity benefits (n = 63), be understanding and nonjudgmental (n = 49), provide accountability (n = 41), and consider physical/mental health conditions (n = 35). Overarching themes emphasized making mental health central to discussions, tailoring discussions to each client, and reframing physical activity as a feasible, enjoyable activity. Conclusions Mental health clients are open to discussing physical activity during therapy if it is approached in a supportive, understanding, and personalized way. Clients’ recommendations can inform future professional development for therapists.

Novel Neural Network Models for Predicting Mental Health Outcomes in the U.S. Youth Population

Anxiety and depression are two of the most pressing mental health issues, particularly among young adults. Given the success of neural networks for predictive modeling, we developed novel neural network models for classifying anxiety and depression using Substance Abuse and Mental Health Services Administration’s Mental Health Client- Level Data (SAMHSA MH-CLD) on 382,174 young adults (15 to 24 years old). The SAMHSA MH-CLD included mental health and general background data collected in 2020 for individuals reporting to state-accredited hospital service centers across the United States. The neural networks were trained on 10% randomized k-folds of the dataset and tested on the remaining 90% for each fold. We found that neural network models predicted anxiety and depression with high accuracy (91.5% to 94.2% accuracy, 8.4% to 3.1% loss), outperforming conventional statistical models. Additionally, for all tested variable sets, our neural network model outperformed expectations for the average therapist consultation (46% to 50% accuracy), as reported previously. For the optimal neural network model with the highest accuracy, the variables most correlated with anxiety and depression were age, education, gender, race, employment, marital status, and stressor events, not accounting for redundant and minimally correlated variables. The effectiveness of our neural network model indicates that it can be implemented alongside therapists in clinical environments to improve psychiatric diagnosis among young adults.

Multidisciplinary perceptions and considerations for spiritual care and biblical framework counseling in mental health

Background: Religious/Spiritual (R/S) care is often desired by mental health clients for culturally sensitive, patient-focused treatment that can promote positive health behaviors and outcomes. Yet providers may be hesitant or overlook this need and treatment guidelines are limited. This mixed-method study aimed to gain insights on existing R/S care, as well as perspectives on what support would be considered for patients choosing Biblical Framework Counseling (BFC) for schizophrenia. This is part of a project aimed to collaboratively extend population-based, mental health care access in resource–constrained communities of both the US, a High-Income Country (HIC), and Low-to-Middle Income Countries (LMICs) in Africa. The project was led by an Africa- Diaspora Citizen Engagement Collaborative (CEC) and is entitled Multi-level Engagement eCoCM (expanded Collaborative Care Model) for Mental Health Integration in Primary and Specialty Care of Resource-Constrained Communities. Methods: A mixed methods approach, comprising of 1) qualitative literature synthesis of 40 journal articles and medical education guidelines for spiritual care, 2) semi-structured survey of 54 multidisciplinary respondents, 3) case report of a patient with schizophrenia treated with Biblical Framework Counseling (BFC), and thematic analysis. Results: The literature review identified multidisciplinary health professional provision of R/S, medical, and/or psychological interventions as monotherapy, concurrent, or integrated strategies. There was a paucity of medical education guidelines. Qualitative themes encompassing literature review, multidisciplinary survey, and BFC case were developed from the extraction of coding categories of disciplines, treatment, and values. Overall themes included 1) there is some multidisciplinary willingness to provide or coordinate R/S care for mental health clients, with varying attitudes about BFC efficacy or implementing biblically based interventions; 2) the ways or extent of care to be provided involves a balance of patient preferences, provider practice considerations and scope; and 3) R/S care implementation can be facilitated via interprofessional education and research that inform on professional and patient-centered values and skills. Survey respondents supported interventions for confirmatory mental health diagnosis and history, scheduled patient follow-ups, ethical hand-offs or referrals, spiritual growth and maintenance, medication management and adherence, and individual psychotherapy depending on professional-patient spirituality congruence, comfort-level with biblical based interventions, and perceived relapse potential. Recognizing both healthcare and spiritual care treatment perspectives and ethical considerations could assist the selection of R/S care approach. Graduate Medical Education (GME) and other health professional programs and guidelines may incorporate these considerations, new and existing R/S interventions, and multidisciplinary provider scope of practice as options for clinician training, mobilization, and design of R/S care practice models. Future research steps should comprise anecdotal case reports, evidence-based case series, and implementation science studies across a broader range of mental disorders.

Mediating effect of adaptive coping between perceived social support and treatment motivation among mental health clients during the Covid-19 pandemic

BackgroundThe repercussions of the COVID-19 pandemic significantly impacted mental health around the world, notably among Filipinos. This global crisis prompted the evaluation of known protective elements that help safeguard mental health. This study analyzed the relationship between perceived social support and treatment motivation as mediated by adaptive coping. MethodsThe participants were selected based on specific criteria and suitability for the study. Data collection utilized online forms of the Multidimensional Scale of Perceived Social Support, Brief COPE, and Client Motivation for Therapy Scale. The reliability and validity of the measurements were confirmed for the chosen population. Mean scores were calculated for perceived social support, treatment motivation, and adaptive coping. The correlation between perceived social support and treatment motivation was examined. Mediation analysis, employing WarpPLS, was conducted to analyze the significance of direct, indirect, and total effects among the three variables in the mediation model. ResultsThe result showed a significant positive correlation between perceived social support and treatment motivation (rs=0.290, p<0.01). Moreover, adaptive coping is a significant mediator between perceived social support and treatment motivation with a small effect size (β=0.213, p<0.001, f2=0.087). The main perceived social support of the respondents is from their significant other (M = 5.03), while their treatment motivation is identified regulation (M = 6.05), and their preferred adaptive coping is positive reframing (M = 5.82). LimitationParticipants are 85 ongoing mental health clients diagnosed with depression and anxiety aged 18 to 39 years old at Quirino Memorial Medical Center during the COVID-19 pandemic. The generalizability of results is limited. ConclusionAdaptive coping significantly mediates the relationship between perceived social support and treatment motivation among mental health clients.

Psychotherapeutic nursing as Advanced Clinical Practice for the promotion of mental health in Spain.

To contribute to the recognition of psychotherapeutic nursing (PTN) as a regulated advanced clinical practice (ACP) in Spain, as is the case in other countries. Nurses are continually evolving to improve overall health outcomes. PTN has become a reality, with several authors describing it as an ACP. In Spain, psychotherapy is not officially regulated, which has led to a significant number of psychiatric nurses adopting an important ACP in this area without recognition. Evidence confirms that PTN possesses the attributes necessary to be considered an ACP. Nurses, like psychotherapists, independently address the complex needs of individuals and families within the context of therapeutic relationships, and there is a pressing need to advance formal processes of regulation and certification. PTN has evolved at different rates depending on local initiatives, policies and various professional interests. In Spain, it is crucial to evaluate its outcomes, recognise it as an ACP and develop training plans for its regulation and accreditation. Mental health nurses in Spain have a strong interest in PTN being recognised as an ACP. To this end, they should join forces with other partners, scientific associations and international bodies such as the International Council of Nurses (ICN) to make PTN an internationally recognised ACP. Psychotherapeutic nurses could contribute to improving mental health outcomes, client satisfaction and health system efficiency, and their formal recognition is an opportunity to enhance their professional identity, competence and autonomy. Nursing policy needs to be reoriented towards strengthening psychotherapy as an ACP. Synergies and alliances between international nursing associations and the ICN can promote its development and implementation, while research, education and leadership are essential to achieving official regulation and accreditation.

Identifying and Assessing Sexual Dysfunction: Strategies for Counselors

Sexual health is a key component of wellness. It includes functioning, satisfaction, social interaction, and access to care. Due to the high prevalence of sexual dysfunction, many mental health clients are likely experiencing sexual dysfunction. However, sexual dysfunction is often not reported by clients, and mental health professionals are usually not trained to identify or assess it. Given that counselors are agents of wellness and that sexual health is considered integrally connected to overall wellness, it is important that counselors understand the most common sexual dysfunctions and assessment techniques. This article offers conceptualizations and strategies to assist mental health professionals in identifying and assessing sexual health problems.

Walk-in mental health: Bridging barriers in a pandemic.

'Single Session Therapy' (SST) is a service delivery model that seeks to provide an evidence-based, solution-focused, brief intervention within a single therapy session. The stand-alone session affords the opportunity to provide brief psychological interventions while clients await access to longer-term services. The COVID-19 pandemic has adversely impacted individuals' mental health. However, the majority of research has investigated patient mental health within hospital settings and community organizations that offer long-term services, whereas minimal research has focused on mental health concerns during COVID-19 within an SST model. The primary aim of the study was to measure client experiences of a brief mental health service. The nature of client mental health concerns who access such services at various points during a pandemic was also investigated. The current study utilized client feedback forms and the Computerized Adaptive Testing-Mental Health (CAT-MH) to measure client experiences and mental health concerns. Qualitative analysis of client feedback forms revealed themes of emotional (e.g., safe space) and informational support (e.g., referrals). Clients also reported reduced barriers to accessing services (e.g., no appointment necessary, no cost), as well as limitations (e.g., not enough sessions) of the Walk-in clinic. Profile analysis of the CAT-MH data indicated that clients had higher rates of depression before COVID-19 (M = 64.2, SD = 13.07) as compared to during the pandemic (M = 59.78, SD = 16.87). In contrast, higher rates of positive suicidality flags were reported during the pandemic (n = 54) as compared to before (n = 29). The lower reported rates of depression but higher rate of suicidality during the pandemic was an unanticipated finding that contradicted prior research, to which possible explanations are explored. Taken together, the results demonstrate the positive experiences of clients who access a single session therapy.

Drivers that influence the development of care and service pathways for mental health clients in health and social service organizations

Background: Investigation, diagnosis, treatment, and follow-ups are the stages of care to be integrated into a care trajectory for clients requiring mental health care (MSSS, 2021). As a result of recent structural reforms, health care organizations are focusing on more integrated care and services in order to respond effectively to the complex needs of this clientele, which poses challenges for the institutionalization of clinical and management practices aimed at better integrating care and services. &#x0D; Objective: To identify the drivers that influence the development of care and service pathways for mental health clients in health and social service organizations. &#x0D; Method: Cross-sectional, descriptive, qualitative, single-case study (CISSS in Quebec) with nested levels of analysis covering the settings of a ""Mental Health Care"" trajectory. The settings include the first, second, and third levels of care. Guided by Longpré's (2017) framework (LO-DISS) linking governance, organizational, structural, and clinical processes with key organizational resources, an interview guide was developed. Clinical professionals, managers, and administrators (N = 10) participated in semi-structured interviews that were analyzed using a qualitative data processing tool (NVivo). Result: Drivers of integrated care and services for mental health care pathways have been identified for each component of the LO-DISS model (2017). These highlighted processes include interdisciplinary collaboration, the patient-partner approach, quality assessment mechanisms, the development of integrative roles (case manager), and the mobilization of environmental and technological resources (electronic records, an environment that supports confidentiality and collaboration). The findings support the notion that investments in resources, processes, also clinical and management practices are key to integrating care and services and providing quality of care. &#x0D; Recommandations: Using the LO-DISS care and services integration model to support renewed clinical governance allows for the deployment of strategies aimed at formalizing clinical and management practices that link the various mental health care pathways experienced by the population. &#x0D;

Evaluation of Individual Placement and Support at Three Community Mental Health Centers in California.

Individual Placement and Support (IPS) has been shown to effectively help people with serious mental illness obtain competitive employment, and IPS programs have been established in over 40 U.S. states and at least 20 other countries. As this expansion continues, the field needs data describing IPS implementation, clients, fidelity, and outcomes in real-world, non-research settings, specifically regarding racial and ethnic disparities and young adults. The goal of this study was to observe the initial three years of IPS implementation, measuring fidelity, client characteristics, and employment outcomes in three mental health agencies in one California county.In 2018, officials in one California county contracted with the IPS Center to provide training and measure IPS program fidelity at three mental health agencies in a large urban area. The goal was to establish and maintain IPS programs with good fidelity and effectiveness. After an initial year of preparation, three mental health programs recruited unemployed clients with interest in employment and implemented IPS. An IPS trainer provided initial training, ongoing consultation, and measured program fidelity. The program clinicians documented client characteristics, IPS service use, and quarterly employment throughout 13 quarters.The project followed 351 mental health clients as they participated in three new supported employment programs over a three-year period. The average client age was 36 years, including 107 (31%) young adults (ages 18-25) and 244 older adults (ages 26+); 177 (50%) identified their gender as female, 173 as male, and 1 as other or declined to answer; 119 (36%) identified as Hispanic, 116 (35%) as non-Hispanic White, 42 (13%) as non-Hispanic Asian, 35 (11%) as non-Hispanic Black, and 20 (6%) as other non-Hispanic. Most clients (78%) had diagnoses of non-psychotic conditions such as anxiety or depression, and 22% had diagnoses of schizophrenia, schizoaffective, or other psychotic disorder. During the project, 312 (87%) engaged in supported employment services, 206 (58%) attained competitive employment, and 177 (50%) found their first job within nine months of enrolling. Hispanics (64%), Asians (57%), and non-Hispanic Blacks (77%) achieved higher employment rates than non-Hispanic Whites (49%). Young adults (73%) achieved higher employment rates than older adults (51%).Engaging in new IPS supported employment programs over several months led to high rates of competitive employment across all groups in real-world, non-research settings, typically within nine months. Hispanics, Asians, and non-Hispanic Blacks achieved higher rates of competitive employment than non-Hispanic Whites, and young adults achieved higher rates than older adults. Further research may explain these differences.

Increases in primary opioid use disorder diagnoses co-occurring with anxiety or depressive disorder diagnoses in mental health treatment in the United States, 2015–2019

BackgroundOpioid use disorders (OUDs) often co-occur with anxiety and depressive disorders. While the proportion of mental health (MH) treatment facilities providing substance use treatment has increased, the proportion of these facilities able to simultaneously treat MH and substance use decreased. This warrants investigation into the integrated treatment needs of persons with a primary OUD diagnosis treated in MH treatment facilities. MethodsUsing the Mental Health Client Level Data, we examined a sample of N = 83,975 adults with OUD as their primary diagnosis who received treatment from a MH treatment facility in the United States from 2015 to 2019. Joinpoint regression was used to examine annual trends of the number of individuals with co-occurring anxiety or depression diagnoses. ResultsMost of the sample were men (53.7%) and received treatment in a community-based program (93.3%). Approximately 17% of the sample had either an anxiety or depressive disorder diagnosis. Approximately 9% of our sample had an anxiety disorder diagnosis, and 10% had a depressive disorder diagnosis. An increase in the number of individuals with a co-occurring anxiety disorder diagnosis from 2015 to 2019 was identified (annual percent change (APC) = 61.4; 95% confidence interval (CI) = [10.0, 136.9]; p =.029). An increase in the number of individuals with a co-occurring depressive disorder diagnosis from 2015 to 2019 was identified (APC = 39.0; 95% CI = [7.4; 79.9]; p =.027). ConclusionsThis study highlights increases in adults receiving MH treatment for OUD having co-occurring anxiety or depression diagnoses, furthering the importance of integrated dual disorder treatment.